A case of the management of developed collateral vessels through left thoracotomy of recurrence of right bronchiectasia with hemoptysis

A 40-year-old woman, with a previous history of right S1, S2 segmentectomy and right middle lobectomy for bronchiectasis with hemoptysis at the age of 24, was admitted for frequent hemoptysis. As a result of a chest roentgenogram, a CT scan and bronchographic examination, a recurrence of bronchiectasis in the right ventral segment of the upper lobe (S3) and the right superior segment of the lower lobe (S6) was diagnosed. The bronchial arteriogram and aortogram showed four vessels going into this region and a shunt lesion was located on located on the proximal side of the pulmonary artery. If a right pneumonectomy had been done, pulmonary function would have gotten worse. If a right thoracotomy had been performed, there would have been much bleeding from the entering vessels. Therefore, a left thoracotomy was preformed and those vessels ligated. The patient is doing well one year after the operation without hemoptysis.     

Correlation between histological grading and the prognosis of prostatic carcinoma--a comparative study of the Japanese General Rules of Prostatic Cancer (JGRPC) and Gleason's classification

One hundred and sixty-seven patients with newly diagnosed, previously untreated prostatic adenocarcinoma, during the period between July, 1971 and March, 1934, were studied. The histopathologic specimens of the prostate were classified by the Japanese General Rules of Prostatic Cancer (JGRPC) and by Gleason's classification. The number of patients with well, moderately and poorly differentiated prostatic carcinomas according to the JGRPC classification was 42, 74 and 51 respectively, and the number of the patients with Gleason's pattern 1, 2, 3, 4, and 5 was 24, 20, 32, 43 and 48, respectively. The number of patients with Gleason's score (primary plus secondary pattern) 2 to 4, 5 to 7 and 8 to 10 groups was 40, 76 and 51 respectively. There was no significant difference in survival rate between well and moderately differentiated groups, but the survival rate of the group with poorly differentiated tumor was significantly lower than that of the moderately differentiated (p less than 0.01) and well differentiated (p less than 0.001) groups. There was no significant difference in 10-year survival rate between the score 2-4 and score 5-8 groups, but the score 9-10 group had a significantly lower survival rate than the score 5-8 group (p less than 0.01) and score 2-4 (p less than 0.005) group. JGRPC and Gleason's classification are thought to be equally useful in estimating prognosis of prostatic cancer, but the former is more concise and easily applicable than the latter.     

Levels of CCK immunoreactivity and dopamine in the nucleus accumbens after 6-hydroxydopamine lesions of the ventral tegmental area and the nucleus accumbens

The effects of 6-hydroxydopamine (6-OHDA) injected into either the ventral tegmental area (VTA) or the nucleus accumbens on dopamine and its metabolite DOPAC and CCK-immunoreactivity in the nucleus accumbens were studied. Measurements were made 1, 3 and 6 weeks after the lesion in both the anterior and posterior part of the nucleus accumbens. 6-OHDA applied in the VTA reduced the level of DA and DOPAC, but did not affect the CCK content in the nucleus accumbens. 6-OHDA lesions in the anterior part of the nucleus accumbens produced depletion of DA and DOPAC from one week after the injection, and decreased the CCK content 6 weeks after the injection. The results suggest that in the nucleus accumbens DA and CCK are localized, at least for the major part, in different nerve terminals.     

Factors influencing the prognosis of grade 1 renal cell carcinoma

Between 1960 and 1988, 65 patients with grade 1 renal cell carcinoma were nephrectomized in our institutions. To delineate potentially curable cancer, the host and tumor factors influencing the prognosis were analyzed. Factors that had unfavorable effects were the presence of tumor thrombi in renal veins, fever, and elevation of erythrocyte sedimentation rate (ESR), serum alpha 2-globulin and C-reactive protein (CRP). Patients who were under 39-years-old or with pT1-2a tumor had excellent prognosis. The ratio of tumor thrombi, pT, fever, ESR, serum alpha 2-globulin and CRP levels all increased with age. In conclusion, patients with normal levels of fever, ESR, serum alpha 2-globulin, CRP and no tumor thrombi and/or with pT1-2a tumor were considered to be the potentially curable cancer patients.